Write-up: Three hours post vax, the pt experienced intense joint pain, headache, fever, occasional nausea and weakness. She continued to have joint pain on and off. Fever and nausea resolved. She took aspirin for the pain.

Write-up: Approximately 10 days, post vax, he experienced generalized muscle aches followed by fever to 102. He was seen by physician. No treatment was given. The most recent information, received on 10/21/99, reports the condition of the pt is ongoing.

Write-up: Immediately following second dose of Lymerix, she experienced arthritis. On 8/17/99, at physician visit, she complained of a one month history of muscle aches, joint aches, etc. She also had a superimposed viral infection with some nausea and upset stomach, starting 8/16/99. Assessment: arthralgia (multiple sites). Dr stated it was possible the pt could have some sort of serum sickness response to the Lyme titer and a rheumatologic exam will be pursued. 9/2/99 Rheumatology consult: She has been treated by a chiropractor for many years due to pain in neck and chest caused by an automobile accident, with improvement. However, more recently, she has developed increasing symptoms of pain and stiffness in her neck, difficulty moving her neck and she awakens with pain and also has paresthesias in both arms. She has a lot of spasms in her neck and also her low back. In the mornings upon waking, she has a difficulty walking down stairs. Dx: arthralgia multiple sites, low back pain, neck pain. Rheumatologist stated that complaints of arthralgias appeared to be temporarily related to Lymerix. Another Dr visit assessment is that she is improving and treated her with Elavil and Doxycycline. The most recent information, received on 11/18/99, reports the condition of the pt is improving.

Write-up: In late June, 1999, she developed a red rash which progressed to large welts. The pt initially thought that she had poison ivy, but the rash has lasted several months. The red rash develops into large welts which can last up to one hour. They then disappear and reappear in a different location. All areas of her body are affected. ER or doctor visit was required. She was treated with Claritin and as of the date of this report was treated with Zyrtec. The most recent information, received on 11/8/99, reports the condition of the pt is ongoing.

Write-up: The pt presented to the dermatologist on 8/2/99, with a back lesion. She believed that the lesion occurred after the first Lymerix dose. Biopsy confirmed the dx of Morphea (localized area). She is currently being treated with topical steroids. There has been no change in the lesion. The most recent information, received on 10/13/99, reports the condition of the pt is ongoing.

Write-up: On 5/20/99, post vax, pt experienced injection site pain, which resolved. Seven days later, he had joint and muscle pain. He also experienced pain in left heel which DR dx''d as possible Achilles tendon. Two days later, he had the same pain in the right heel and was treated with anti-inflammatories for a few days and used crutches. In June or early July, 1999, he was dx''d and treated gouty arthritis in his right large toe joint, with colchicine and allopurinol. Cytosac was prescribed to buffer his stomach. In August he was treated with an antibiotic (in case he had Lyme disease) for 10 days, which did not help the muscle and joint pain, so it was stopped. Today his right elbow is sore. His present treatment is Indomethacin and Tylenol. Colchicine and allopurinol were discontinued. Lymerix was also discontinued. The most recent information, received on 10/12/1999, reports the condition of the pt is ongoing.

Write-up: Joints do not bend well (joint disorder nos). Muscle soreness. Sixteen days post vax, pt experienced muscle soreness in legs. Additionally he found it difficult to bend his ankles, shoulders, and finger joints. He was treated with aspirin. He reported that symptoms were gone within the next week and he was back to normal again. Most recent information received on 11/30/99 reports the condition is resolved.

Write-up: Approximately 3 months, post vax, in August, 1999, the pt began to experience arthralgia. His symptoms are in multiple joints. The most recent information, received on 11/23/99, reports the condition of the pt is ongoing.

Write-up: Six hours, post vax, the pt experienced swelling (nos) and joint pain. No treatment was given. Symptoms resolved 3-4 months later. The most recent information, received on 12/15/1999, reported the condition of the pt is resolved.